摘要目的：探讨门冬氨酸鸟氨酸防治经内镜逆行性胰胆管造影术（ERCP）治疗胆源性胰腺炎后肝功能损伤的临床价值。方法选取2011年7月至2015年6月接受 ERCP 治疗后肝功能受损的56例胆源性胰腺炎患者，按住院顺序编号，均分为对照组与观察组，每组28例。对照组给予常规治疗，包括胃肠道减压、预防感染、胃肠外营养支持治疗，观察组在此基础上加用门冬氨酸鸟氨酸治疗，比较两组治疗前后天门冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）、总胆红素（TBIL）、γ-谷氨酰转肽酶（GGT）等肝功能指标的变化，统计两组腹痛缓解时间、血淀粉酶（AMS）复常时间与住院时间，并测定两组血清白细胞介素-1（IL-1）、白细胞介素-6（IL-6）及肿瘤坏死因子-α（TNF-α）等炎症因子的变化。结果①治疗1周，两组 ALT、AST、TBIL、GGT 均降低，与治疗前比较差异有统计学意义，观察组降低幅度高于对照组（P ﹤0.05）；②治疗1周，两组各炎性因子水平均降低，与治疗前比较差异有统计学意义，观察组降低幅度高于对照组（P ﹤0.05）；③观察组腹痛缓解时间、AMS 恢复正常时间及住院时间均短于对照组（P ﹤0.05）。结论门冬氨酸鸟氨酸可减轻 ERCP 治疗胆源性胰腺炎后患者肝功能损伤，降低患者血清炎性因子水平，缩短其术后恢复时间。

abstractsObjective To investigate the clinical value of ornithine aspartate in prevention and treatment of hepatic injury in patients with biliary pancreatitis after endoscopic retrograde cholangiopan-creatography(ERCP). Methods From July 2011 to June 2015,56 patients with biliary pancreatitis and hepatic injury after ERCP were selected. According to the order of hospitalization,the patients were num-bered and equally divided into control group and observation group,with 28 cases in each group. The control group was given routine treatment,including gastrointestinal decompression,prevention of infec-tion and parenteral nutrition support treatment. On this basis,the observation group was treated with orni-thine aspartate. The changes of aspartate aminotransferase(ALT),alanine aminotransferase(AST),to-tal bilirubin(TBIL),γ-glutamyl transpeptidase(GGT)and other liver function indexes before and after treatment were compared between the two groups. The relief time of abdominal pain,time of blood amyl-ase(AMS)returning to normal level and hospitalization time in the two groups were statistically ana-lyzed. The changes of serum interleukin 1(IL-1),interleukin 6( IL-6),tumor necrosis factor alpha (TNF-α)and other inflammatory cytokines in the two groups were determined. Results ①After one week of treatment,the levels of ALT,AST,TBIL and GGT in the two groups were lower than those be-fore treatment,and the decreasing amplitude in the observation group was greater than that in the control group(P ﹤ 0. 05);②After one week of treatment,the levels of inflammatory factors in the two groups were lower than those before treatment,and the decreasing amplitude in the observation group was greater than that in the control group(P ﹤ 0. 05);③The relief time of abdominal pain,time of AMS returning to normal level and hospitalization time of the observation group were shorter than those of the control group (P ﹤0. 05). Conclusions Ornithine aspartate can reduce the hepatic injury in patients with biliary pancreatitis after ERCP,and reduce the levels of serum inflammatory cytokines and shorten the recovery time after operation.